The U.S. Agency for International Development, Office of U.S. Foreign Disaster Assistance (USAID/OFDA) initiated the Program for Enhancement of Emergency Response (PEER) with an aim to build local and regional capacities in disaster risk reduction and management through disaster preparedness training. ADPC managed the first phase of PEER until 2003, targeting India, Indonesia, Nepal, and Philippines. Under the second phase, PEER expanded to cover Bangladesh and Pakistan under the auspices of the National Society for Earthquake Technology (NSET). All six countries, as noted in the prior section, have a high hazard vulnerability and clear need for improved disaster response readiness.

In order to gather quantitative as well as qualitative information to assess the needs of the PEER 2 partner countries, and the proposed PEER 3 HOPE pilot countries (Cambodia, Lao PDR, and Vietnam), ADPC and our partners consulted the last PEER 2 M&E report submitted in September of 2007. In order to determine the most effective and results-focused approach to implementing PEER 3, we briefly highlight the most significant accomplishments of PEER 1 and 2, as well as the primary challenges experienced under PEER programming to date.

Significant accomplishments under PEER 1 and 2 include:
- Quality instructors that adhere to standards: PEER has developed a solid roster of instructors in each of the country following the standards set in the program. These instructors are utilized to further the training within their respective institutions and countries and across the region, Pakistan specifically as a new partner
- Institutionalization: Each country has recognized institution(s) implementing PEER and continuously developing responders and instructors utilizing the adapted and translated materials - Trained responders: In the region these responders constitute most of the response personnel deployed for in-country emergencies.

The three main overarching challenges to date appear to be:
- High rates of attrition for PEER instructors and end users
- The need for appropriate targeting to reach first responders and decision-makers
- Institutionalizing PEER at the national level

ADPC Team through American Red Cross (ARC) will work directly with the headquarter staff at the NS, relying heavily on the Master Trainers from PEER 1 and 2, to adapt high quality, streamlined course material to fit each context. This will not only promote retention of previously trained participants, but give them opportunities to reinforce their acquired skills through application. The ADPC Team through ARC will seek their support for initial regional curriculum review, and for the initial pilot testing of the course (likely in the Philippines). MTs would then implement the first round of trainings at the National Societies headquarters, with Branch Level participants attending, and then serve as on-call technical assistance for future course delivery throughout the duration of the program. It is envisioned MTs will be needed as PEER 3 expands to more communities. Refresher courses will be offered on a regular basis to keep MTs engaged and exposed to new skill development. It is envisioned local training coordinators would be positioned in each country to facilitate the work under this objective and minimize initial burden on the NS. (This may take different shape for Indonesia, Pakistan and the Philippines with the OFDA PEER Country Consultants hired for these countries).

The PEER-HOPE Program will be continued in all the PEER countries(Bangladesh, Indonesia, India, Nepal, Pakistan and Philippines) for enhancement of the prepardness capacity of hospital and also to institutionalize the Hospital Preparedness for Emergencies (HOPE) Program through building upon the accomplishment and experience of the PEER-HOPE Program during stage I&II .Our approach is designed to incorporate lessons learned and best practices from PEER 1 and PEER 2, while continuing to support the goals and initiatives of the current HOPE implementing partners and government counterparts- Health Ministries.In order to achive the expected results in Institutionalization, it requires the respective governments to continue the process and carry-on the responsibility of training, monitoring and coordinating courses and application. More HOPE training will be conducted utilizing existing HOPE regional and national trainers where there is a shortage of Instructors for such countries to develop their own cadre of HOPE trainers. Attempt also will be made to institutionalize HOPE training within new implementing institutions like medical universities/colleges and other related training institutions or department within the ministries of health of the target countries. HOPE training program will be continued in PEER countries through an integrated and streamlined approach, focusing on long-term sustainability, leveraging resources, and raising the professional profile of Health sector professionals in the region. As with all proposed activities, the ADPC Team will undertake all tasks with a view toward the PEER 3 cross cutting areas: capacity building, gender, and program integration.

The PEER 3 Program Manager in conjunction with Project team and in-country project coordinators is responsible for the preparation and submission of the above reports that form part of the monitoring process. The Inception Report, Annual Program Report, Project Implementation Review, Quarterly Progress Reports, Periodic Thematic Reports, and Program completion Report are related to monitoring, while the Technical Reports and Project Publications have a broader function and the frequency and nature will be refined during implementation in consultation with USAID/OFDA. Documentation of lessons learned and best practices will be a key M&E program work. Results from the program will be disseminated within and beyond the program partners through the PEER web site and other information-sharing networks and forums.

View 2. PHE : project no139 and 157 (PEER phases 1 to 3) in a larger map